Vitamin D deficiency rickets

Definition

Most manifestations of rickets are due to skeletal changes. Craniotabes is a softening of the cranial bones and can be detected by applying pressure at the occiput or over the parietal bones. The sensation is similar to the feel of pressing into a Ping-Pong ball and then releasing. Widening of the costochondral junctions results in a rachitic rosary, which feels like the beads of a rosary as the examiner’s fingers move along the costochondral junctions from rib to rib. Growth plate widening is also responsible for the enlargement at the wrists and ankles. The horizontal depression along the lower anterior chest known as Harrison groove occurs from pulling of the softened ribs by the diaphragm during inspiration. Softening of the ribs also impairs air movement and predisposes patients to atelectasis and pneumonia. These children have an increased risk of pneumonia and muscle weakness leading to a delay in motor development.

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